Organization
FAMILY SERVICE OF LAKE COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANA NUNEZ (CLINICAL CARE COORDINATOR)
(847) 432-4981
Entity
Organization
Contact information
Practice address
777 CENTRAL AVE, HIGHLAND PARK, IL 60035
(847) 432-4981
(847) 432-7331
Mailing address
777 CENTRAL AVE, HIGHLAND PARK, IL 60035-3240
(847) 432-4981
(847) 432-7331
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004915366
BLUE CROSS BLUE SHIELD
IL
Enumeration date
01/11/2007
Last updated
08/25/2022
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